1985-407 BUILDING PERMIT
TOWN OF QUEENSBURY No 85 - 407
oe . kc` _ )l WARREN COUNTY, NEW YORK -
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PERMISSION is hereby granted to Lois Hammond a
1 to
OWNER of property located at L,! ts Pine Streete West Glens Fallsgtreet, Road or Ave.
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in the Town of Queensbury, To Construct or place a Sewage Alteration
at the above location in accordance to application together with plot plans and other information hereto filed and t
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1 . OWNER'S Address is 18 Pine St .
West Glens Fallsr N . Ye
2, CONTRACTOR or BUI LDER'S Name p~p
rd
Sanitary Sewer Service '
m
3_ CONTRACTOR or BUILDERS Address Cn
P . o . Box 224 r*
Glens Falls , New York m
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4. ARCHITECT'S Name
6. ARCHITECTS Address
6. TYPE of Construction — (Please indicate by X)
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i ) Wood Frame I I Masonry I ) Steel 11 IL
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7. PLANS and Specifications
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No- 1000 gallon tank , dist . box and l 7 r x8 t drywell O
# 3 stone per plot and application submitted .
S. Proposed Use
Sewage system for dwelling p
$ 30 00 PERMIT FEE PAID -- THIS PERMIT EXPIRES August 5 19 87
(if a longer period is required an application for an extension must he made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 5th Day of z5.tzgja8t- 19 85
SIGNED BY for the Town of Queensbury
-- -- - Building and Zoning Inspector fy�
`t TOWN OF OUEENSBURY
R
BUILDING & ZONING DEPARTMENT TOWN OF QUEENSSURY
SEWAGE DISPOSAL PERMIT APPLICATION Lam,� 0 It � U
1 . Owner ' s Name ZCD I 1 31" +C]N� U 1985 of
Address F' '
Telephone No . C7
2 . Property location Am ,g
3 . Name of person or firm responsible for installing system
Telephone No . f
Address ('l _ fx4_ C G `
40 Number of bedrooms ( residential buildings only )
5 . Daily flow _ / ,1! a gallons/day
6 . Septic tank capacity gallons
7 . Topography : Koflat rollin steep
o slope
8 . Nature of soil and depth
9 . if ground water , bedrock or impervious m erial is apparent at what
depth does it begin? ft .
100 Percolation test : A iw is reauire
B is not re aired
C If required w at is t o rateminutes/ inch
110 Water supply : municipal well , other
12 , Type of system proposed : drywell tile field , other
Any contractor , corporation , individual , etc . engaged in the construction
of a sanitary sewage disposal system who covers the same before inspection ,
does not have an approved permit , or varies from the approved application
will be subject to a penalty of $ 250 as prow ' for in Section 6 . O10 of the
Queensbur Sanitary Sewage Ordinance . 7
Date (7 ,--r
-- nature of a A-cant
On separate sheet of paper submit a diagr of the proposed septic system
with all dimensions , including distance from any structure , distance from
property line and domestic water supply , etc . Include all dimensions of
the system itself . ) _.OgPC f
Farm 3 ^' 82 Y � � ,f ',Gy !/ J.( • �� �� �, '�
3 rt7a 1 AD wd5 411
TC3WN OF WEENSBURY
Building Department
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lmwoc �sas Report ��'�"'-7r- -
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Permit No. :e6- '�' Weather
,Remarks
SxcatYa txon
Footin Forms
Footin & Pieri
Foundation
Cemer►t Coat
Water roofing
Backfill
Final curve
Fr
Shea thi n
Roof Fell t
Rooffn
,Siding
Masonr Veneer
Rau h Pl
Relief valves
Wall Board
8xtIn Porches
Fi naE shed Floor
Interior Tr!M
Stairs & Railings
Cellar Dr . Tile
Concrete Floors
PI . Fixtures
Gar . Fire roofin
Door Closers
ChiAmne
Water Meter Inst ,
Se tic A xoval
Floors �-- --� -
Founda tion �.. ,... —
Tnsulatzon Walls -
Su,ildl Inspector
REMARKS IS
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